Did your doctor forget to tell you about many common headache causes and cures? What’s the first thing you do to try to relieve an irritating headache? Swig down an extra cup of coffee? Raid the medicine cabinet and pop a couple of ibuprofen? Rub your throbbing temples? Migraine sufferers may have to dig a bit deeper to get relief, using neurologist-prescribed triptans, antihistamines, anti-seizure drugs, or antidepressants, to treat their pain. In extreme cases even sedatives may be prescribed to help sufferers sleep off the pain. But does any of this actually cure your headache?
While all of these things may provide some headache and migraine relief, the relief is only temporary. If you want to cure your headaches and migraines, you can’t just put a Band-Aid on your pain. You have to find the source.
Find the Cause of Your Headache
Until you find and cure the cause of your headaches, they will always come back. If your car tire has a slow leak, you don’t just keep filling it with air, hoping the leak will eventually seal itself. No, you find the hole, the source of the leak, and you fix the problem. Why should a headache be treated any differently? Find the cause, the source, of your headache, and get the problem fixed.
Choose the Right Professional for the Job
Neurologists and other traditional doctors focus on diagnosing and treating vascular headaches (migraines) and throw drugs at the symptoms. They are reactive, reacting to your current pain and “fixing” it with temporary relief—a prescription to take every time you get a headache. They know your headache will come back; that’s why they write you a prescription…with refills. This is because many neurologists generally don’t have the training to find and cure the cause of your headaches.
Musculoskeletal (MSK) practitioners, like chiropractors, physical therapists, acupuncturists, and massage therapists, are focused on finding and treating the cause of your headaches. However, sometimes despite their best efforts they can only provide short-term relief. So where can you go when that happens? Find a physician who understands where headaches originate from in the MSK system.
Most headaches have an MSK origin, yet since your family doctor is more likely to only have been exposed to the neurology view, the real causes of headaches are often missed in traditional medicine. What are those causes?
The 7 Headache Causes
Regrettably, despite the fact that most headaches stem from an MSK issue, it’s unlikely your family doctor or neurologist has ever heard of the 7 most common types of headache causes that follow:
- Injured neck joints—Your neck has joints, just like your fingers, called “facet joints.” The upper neck joints (C0–C3) can cause headaches when they get injured. How can they get injured? In a car crash or when you fall and hit your head (or something hits your head). These joints can also become arthritic without injury.
- Loss of cervical curve—Your neck needs to have a c-shaped curve so the weight of your head is distributed evenly between the discs in the front and the facet joints in the back. When you lose the curve, the neck muscles that attach to the back of the skull can get irritated and this can activate nerves that send pain into your head.
- Laxity of neck ligaments causing instability—The upper neck has ligaments that hold it together. When these are injured and stretched, the nerves, discs, and facet joints can become irritated or damaged, and the muscles get overworked trying to stabilize the area (see above). This problem is most commonly caused by car crashes and can be easily diagnosed with a technology known as DMX, which is a video x-ray while you move. In addition, when the discs in the neck degenerate with age, the ligaments can get stretched leading to sloppy movement. This then has the same effect
- Irritated nerves—There are nerves at the back of the head that can cause headaches. The two most commonly involved are the greater and lesser occipital nerves. These can be irritated by bad posture, loss of neck curve, instability, and so on. In addition, there are small muscles at base of the skull that connect into the covering of the brain called the dura. When these muscles spasm they can yank on the dura leading to headaches.
- Weak muscles—The most common weak muscles that lead to headaches are the deep neck flexors (DNFs) in the front of the neck. However, weak muscles can also be found in the upper neck or even at each level in the back of the neck. These lead to areas that are unstable and the extra wear and tear on discs, joints, and tendons can also lead to headaches.
- Trigger points—Trigger points are areas in the muscle that are tight and weak and cause pain. Many different muscles in the neck (and a few in the head) can cause headache. This is referred pain, where a spot in the muscle shoots pain to the head.
- Poor posture— Postural issues, like a forward head and rounded shoulders, can cause the muscles at the back of the head that attach to the skull via tendons to get overworked. Once their design specifications are exceeded by being used to hold up the head, tendinopathy can result with pain at the back of the head. Over time, the tendons can get degenerated and develop micro tears.
The 7 Headache Cures and Treatments
As the song goes, “The back bone’s connected the neck bone. The neck bone’s connected to the head bone…” The musculoskeletal system is all connected, so you may need one or several of these treatments to help your headaches.
- Repair injured neck joints (facet joints)—Manipulative therapies through chiropractors, osteopaths, or physical therapists can often help. Injecting concentrated platelets into the joints under precise x-ray guidance may also help heal the damage. Be careful here; while a C2–C3 facet injection is commonly performed with steroids (which is bad for the joint), finding a practitioner with considerable experience to inject the higher joints (C0–C2) that can also cause headache can be difficult. As an example, there are likely less than 50 providers in the U.S. who have injected more than 100 patients at the C0–C1 level (our Colorado clinic has performed several thousand of these procedures).
- Restore your cervical curve—Find an experienced chiropractor who knows how to restore the curve. Check out idealspine.com to find someone in your area. Prolotherapy in the neck to tighten the ligaments in the back of the spine can also be helpful if curve restoration only provides temporary relief.
- Reinforce ligament stability—If the sole cause of your instability is weak muscles, specialized exercises may help (see below). However, if exercise flares up the problem or isn’t working, then the other half of the stability equation is ligaments. Another treatment method focusing on this system is very precise injections of concentrated platelets into the damaged ligaments (see discussion above on upper cervical facet injections, as these must be performed under highly specialized imaging guidance).
- Chill out irritated nerves—The nerves can often be treated via precise injection under ultrasound guidance using a regenerative nerve procedure, like our advanced third-generation platelet lysate.
- Restrengthen weak muscles—Deep neck flexors can be strengthened with a very specific protocol developed by physical therapists at the University of Queensland in Australia. The other muscles can be strengthened with specialized machines, like a BTE multi-cervical unit. For the high upper-neck muscles, we’ve developed an iPhone accelerometer-based strengthening protocol that provides instant feedback to the patient.
- Eliminate trigger points— Regrettably, the identification and treatment of trigger points has become a lost medical art due to changes in reimbursement for trigger point injections over a decade ago. However, one of our old physical therapists has been able to spread a trigger point dry-needling technique across the country, so many well-trained physical therapists are now out there who can treat these trigger point issues with an acupuncture needle. See http://www.kinetacore.com/. Don’t confuse this technique with traditional Chinese acupuncture, as most acupuncturists aren’t trained to treat muscle trigger points.
- Reset proper posture—Early on, the effects of poor posture can be helped by a postural physical-therapy program. One of the best we’ve ever seen can be found at egoscue.com. If that doesn’t work, then the above may be needed to help things along.
The upshot? While Motrin or Excedrin or triptans may relieve your headache or migraine, no drug is a safe long-term solution. Find the cause of your headaches and seek out treatments to cure or at least manage it long-term. Be proactive and stop that next headache before it starts!
To find out if you might be a candidate for a Regenexx procedure to address the cause of your headaches, complete our Regenexx Procedure Candidate Form online.